Deaths, crimes and violence not classified as a crime among children and adolescents in Maranhão, Brazil (2014 to 2020)

Silva, Daniel Portela Aguiar da; Ribeiro, Marizélia Rodrigues Costa; Branco, Maria dos Remédios Freitas Carvalho; Marques, Márcio Thadeu Silva; Almeida, Joelson dos Santos; Gomes, Jamesson Amaral; Silva, Antônio Augusto Moura da

doi:10.1590/1413-81232023282.08342022

Abstract

This study compares temporal trends in violent deaths of children and adolescents and analyzes differences in incidents of violence classified and not classified as a crime. We analyzed data from the Mortality Information System and State of Maranhão Public Security Department for the period 2014 to 2020. Child and adolescent were defined as aged 0-11 and 12-17 years old, respectively. Types of violence were organized according to the groups, subgroups, and types of crimes set out in Brazil’s penal code. A total of 1,326 deaths and 8,187 incidents of violence were reported, both of which were more frequent in adolescents. The most frequent types of violence in children and adolescentes, respectively, were: abduction of incapable persons (p < 0.001), abandonment of incapable persons (p = 0.045), rape of vulnerable persons (p = 0.003); homicides (p < 0.001), crimes against individual freedom (p = 0.004), crimes against sexual freedom (p < 0.001), psychological violence (p = 0.034). Domestic violence with bodily harm was more frequent in girls (p < 0.001), while severe bodily harm (p=0.002), homicide (p < 0.001), and harassment (p < 0.001) were more frequent in boys. The findings reveal differences over time in deaths and incidents of violence classified and not classified as crime among both children and adolescents.

Key words:
Adolescent; Child; Death; Violence

Introduction

The term “violence against children and adolescents” encompasses historical social phenomena that are manifested in different ways depending on culture, race, socioeconomic conditions, and age¹1 World Health Organization (WHO). Global status report on preventing violence against children. Geneva: WHO; 2020.^,²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006.. All types of violence should be considered a public health problem because violence jeopardizes health, dignity, and human development¹1 World Health Organization (WHO). Global status report on preventing violence against children. Geneva: WHO; 2020.

2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006.^-³3 Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018.. It is estimated that one out of two children aged 2-17 years experiences some form of violence each year¹1 World Health Organization (WHO). Global status report on preventing violence against children. Geneva: WHO; 2020..

The World Health Organization defines violence as the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation¹1 World Health Organization (WHO). Global status report on preventing violence against children. Geneva: WHO; 2020.. Within the sphere of human rights, one of the core elements of Brazil’s public security system, the term violence refers to any violation of civil, political, social, economic, or cultural rights³3 Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018..

Policies to tackle violence against children and adolescents were created after the enactment of the 1988 Federal Constitution, especially in response to the provisions of the Child and Adolescent Statute (ECA)⁴4 Brasil. Ministério da Mulher, da Família e dos Direitos Humanos (MMFDH). ECA: Estatuto da Criança e do Adolescente - Lei nº 8.069, de 13 de julho de 1990. Brasília: MMFDH; 2019.. The mandatory reporting and referral of suspected and confirmed cases of violence against children aged up to 17 years to the child protection services and other competent bodies has given greater visibility to this issue and improved violence surveillance and efforts to tackle this problem in Brazil⁵5 Macedo DM, Foschiera LN, Bordini TCPM, Habigzang LF, Koller SH. Revisão sistemática de estudos sobre registros de violência contra crianças e adolescentes no Brasil. Cien Saude Colet 2017; 24(2):487-496.^,⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021..

However, the underreporting of cases, in conjunction with other factors, hamper the collection of accurate epidemiological data on violence against this age group⁵5 Macedo DM, Foschiera LN, Bordini TCPM, Habigzang LF, Koller SH. Revisão sistemática de estudos sobre registros de violência contra crianças e adolescentes no Brasil. Cien Saude Colet 2017; 24(2):487-496.

6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021.^-⁷7 Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021. It is also important to highlight the lack of research analyzing data from state public security departments⁵5 Macedo DM, Foschiera LN, Bordini TCPM, Habigzang LF, Koller SH. Revisão sistemática de estudos sobre registros de violência contra crianças e adolescentes no Brasil. Cien Saude Colet 2017; 24(2):487-496.^,⁸8 Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915., the need to make data on violent deaths and/or sexual violence accessible to a wider audience⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021.^,⁷7 Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021; the lack of emphasis given to specific factors associated with childhood and teenage violence; and mistakes in filling in police incident report forms⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021..

Epidemiological studies of violence against children and adolescents in the State of Maranhão are scarce⁹9 Instituto Maranhense de Estudos Socioeconômicos e Cartográficos (IMESC). Boletim Social do Maranhão. IMESC 2020; 2(4):1-46.

10 Sociedade Maranhense de Direitos Humanos (SMDH). Monitoramento da violência no Maranhão. São Luís: SMDH; 2017.

11 Sousa AYA, Pinho EFS, Silva JTN, Meireles ACV, Lago RJM, Silva WN, Moraes FC. Caracterização dos casos de violência sexual contra a mulher notificados no estado do Maranhão no período de 2009 a 2017. BJD 2021;7(1):9925-9941.^-¹²12 Conselho Estadual dos Direitos da Criança e do Adolescente do Maranhão, Centro de Defesa dos Direitos da Criança e do Adolescente Pe. Marcos Passerini. Observatório Criança: acompanhando a situação dos direitos da criança e do adolescente no Maranhão de 2006 a 2010. São Luís: CEDCA/CDMP; 2014.. In addition, access to data from the state public security department is poor, justifying the present study¹²12 Conselho Estadual dos Direitos da Criança e do Adolescente do Maranhão, Centro de Defesa dos Direitos da Criança e do Adolescente Pe. Marcos Passerini. Observatório Criança: acompanhando a situação dos direitos da criança e do adolescente no Maranhão de 2006 a 2010. São Luís: CEDCA/CDMP; 2014..

Based on these considerations, we formulated the following hypotheses: a) temporal trends in violence and deaths due to violence differ between children and adolescents; b) the distribution of violence, regardless of whether the incident is classified as a crime or not, differs between children and adolescents and according to sex. We therefore analyzed differences in deaths due to violence and incidents of violence among children and adolescents, regardless of whether the incidents were classified as a crime or not, in the State of Maranhão in the period 2014 to 2020.

This study takes a step forward in relation to other studies on this topic⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021.

7 Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021

8 Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915.

9 Instituto Maranhense de Estudos Socioeconômicos e Cartográficos (IMESC). Boletim Social do Maranhão. IMESC 2020; 2(4):1-46.

10 Sociedade Maranhense de Direitos Humanos (SMDH). Monitoramento da violência no Maranhão. São Luís: SMDH; 2017.

11 Sousa AYA, Pinho EFS, Silva JTN, Meireles ACV, Lago RJM, Silva WN, Moraes FC. Caracterização dos casos de violência sexual contra a mulher notificados no estado do Maranhão no período de 2009 a 2017. BJD 2021;7(1):9925-9941.

12 Conselho Estadual dos Direitos da Criança e do Adolescente do Maranhão, Centro de Defesa dos Direitos da Criança e do Adolescente Pe. Marcos Passerini. Observatório Criança: acompanhando a situação dos direitos da criança e do adolescente no Maranhão de 2006 a 2010. São Luís: CEDCA/CDMP; 2014.

13 Lima AT, Sousa RPR, Clemente SMPS, Viana MAO, Porto E. Perfil epidemiológico da violência contra crianças e adolescentes: uma análise das notificações compulsórias no Estado da Paraíba. Res Soc Dev 2020; 9(10):e1359108421 .

14 Lolli LF, Mesacasa D, Campos FNL, Silva NS, Oliveira VA, Fabiano GR, Dalpoz GQ, Pimentel BV, Freitag IH, Sperandio KCT. Violência praticada contra crianças e adolescentes no estado do Paraná: estudo retrospectivo do quinquênio 2010-2014. Braz J Hea Rev 2020; 3(4):11198-11214.

15 Oliveira NF, Moraes CL, Junger WL, Reichenheim ME. Violência contra crianças e adolescentes em Manaus, Amazonas: estudo descritivo dos casos e análise da completude das fichas de notificação, 2009-2016. Epidemiol Serv Saude 2020; 29(1):e2018438.

16 Cezar PK, Arpini DM, Goetz ER. Registros de notificação compulsória de violência envolvendo crianças e adolescentes. Psicol Cienc Prof 2017; 37(2):432-445.^-¹⁷17 Quadros MN, Kirchner RM, Hildebrandt LM, Leite, MT, Costa MC, Sarzi DM. Situação da violência contra crianças e adolescentes no Brasil. Enfermería Global 2016; 15(44):174-185. insofar as it analyzes differences between types of violence based on the groups (titles), subgroups (chapters), and types of crime set out in Brazil’s penal code stratified by sex, including crimes such as abandonment, parental abduction, and rape of a vulnerable person, and incidents not classified as crimes, such as disappearance of children and adolescents.

Methods

We conducted a cross-sectional epidemiological study using two types of data on violence against children and adolescents reported in Maranhão during the period 2014 to 2020: a) deaths recorded in Brazil’s Mortality Information System (SIM); b) incident records obtained from the State of Maranhão Public Security Department (SSP-MA).

Study location and population

One of the nine states in Brazil’s Northeast Region, Maranhão had an estimated population of 6,875,302 in 2014, including 1,288,870 children aged 0-9 years, 545,846 aged 10-13 years, and 578,504 aged 14-17 years. By 2020, the overall population had increased to 7,114,598 and the number of children in these age groups had fallen to 1,175,312, 515,930, and 550.077 respectively¹⁸18 Instituto Brasileiro de Geografia e Estatística (IBGE). Sistema IBGE de Recuperação Automática: projeção da população [Internet]. [acessado 2021 out 10]. Disponível em: https://sidra.ibge.gov.br/Tabela/7358
https://sidra.ibge.gov.br/Tabela/7358... .

The study population consisted of cases of death due to violence recorded in the SIM and suspected or confirmed cases of violence against children and adolescents recorded in civil police incident reports (IRs). Child and adolescent were defined as age 0-11 and 12-17 years, respectively⁴4 Brasil. Ministério da Mulher, da Família e dos Direitos Humanos (MMFDH). ECA: Estatuto da Criança e do Adolescente - Lei nº 8.069, de 13 de julho de 1990. Brasília: MMFDH; 2019..

Data collection

Data on incidents of violence were collected from the Integrated Operational Management System (SIGO), for incidents occurring between 2014 and 2018, and SSP-MA’s Integrated Management System (SIGMA), for incidents occurring in 2019 and 2020. Data for the years prior to 2014 were not collected because they were not available.

Data on deaths were collected in June 2021 from the SIM, accessed via the homepage of the country’s national health information system (DATASUS). These deaths are classified in the following core categories: self-inflicted injuries, assault and legal interventions, and operations of war¹⁹19 Brasil. Ministério da Saúde (MS). Sistema de Informações sobre Mortalidade [Internet]. [acessado 2022 mar 10]. Disponível em: https://dados.gov.br/dataset/sistema-de-informacao-sobre-mortalidade
https://dados.gov.br/dataset/sistema-de-... ^,²⁰20 Departamento de Informática do Sistema Único de Saúde (DATASUS). Informações de Saúde: mortalidade [Internet]. [acessado 2021 out 10]. Disponível em: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10uf.def
http://tabnet.datasus.gov.br/cgi/deftoht... .

SIGO and SIGMA

The Civil Police of the State of Maranhão adopted the SIGO as its standard operating system in 2012²¹21 Maranhão. Delegacia Geral da Polícia Civil (DGPC). Portaria nº 032, de 2 de fevereiro de 2012. Adota a ferramenta de solução tecnológica SIGO (Sistema Integrado de Gestão Operacional) como sistema padrão a ser utilizado para gestão operacional por toda a Polícia Civil do Estado do Maranhão. Diário Oficial do Estado do Maranhão 2012; 7 fev.. On 27 June 2018, SIGMA was recommended as the preferred system for the formulation of electronic IRs²²22 Maranhão. Delegacia Geral da Polícia Civil (DGPC). Portaria nº 430, de 27 de junho de 2018. Regulamenta a utilização de soluções tecnológicas e não tecnológicas como padrões a serem utilizados por toda gestão operacional da Polícia Civil do Estado do Maranhão. Diário Oficial do Estado do Maranhão 2018; 27 jun., becoming the only system used by the force in 2019.

The officers responsible for entering the information from the IRs into the SSP-MA systems name the incidents according to the conduct of the probable perpetrator based on the type of crimes contained in the Penal Code and/or specific legislation (ECA and Maria da Penha Law, among other). When the conduct is not classified in the Penal Code or specific legislation because it is not a type of crime, the officers name the incident according to the nature of the violence²³23 Maranhão. Instrução Normativa nº 002, de abril de 2012. Normatiza e disciplina os procedimentos policiais e outros atos da Polícia Civil. Diário Oficial do Estado do Maranhão 2012; 23 mai..

The categories of information from IRs included in the SSP-MA’s systems are type of incident, date, time, location, location type, and the full name, alias and address of the individuals involved. The sex of the probable perpetrator and their relationship with the victim are not included in the SIGMA databases. This information was therefore collected directly from the electronic IRs from 2019 and 2020. We were unable to obtain this information from the SIGO because it was not possible to create a new password for this system. Information on the victim’s family income, education level, and skin color were not included in the IRs used to enter the data into SIGMA.

Variables based on the Penal Code

Since the SSP-MA bases the classifications of violence on the Penal Code, types of violence were organized into groups (corresponding to the titles of the Penal Code), subgroups (corresponding to the chapters of the Penal Code), and types of crime²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

The groups and respective subgroups were as follows: a) crimes against persons (bodily harm, crimes against individual liberty, crimes against life, endangerment of life and health, and crimes against honor); b) crimes against sexual dignity (sexual crimes against vulnerable persons, crimes against sexual freedom, indecent public behavior); c) incidents not classified as crimes (disappearance of persons, suicide, psychological violence); d) crimes against the family (crimes against parental power, custody and guardianship, including parental abduction); and e) crimes against property (robbery, including robbery murder)²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

The subgroup bodily harm includes the crimes bodily harm, domestic violence, and other. Bodily harm is defined as any offence against someone’s bodily integrity or health. Domestic violence is when the perpetrators are family member or a person who lives/has lived with the victim in a home environment. Other include types of bodily harm that endanger life or result in death²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

Crimes against individual liberty occur when a person’s liberty is violated. This subgroup consists of the crimes threats, criminal coercion, and other. A threat is when someone intimidates another person into believing that they will cause serious harm. Criminal coercion is the use of violence or serious threats to force someone to break the law. Other includes the crimes shaming or embarrassing a child or adolescent, abduction, and false imprisonment of a minor under the age of 18²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

Endangerment of life and health is defined as putting someone’s life or health at direct imminent risk. Related crimes include maltreatment, abandonment of an incapable person, and torture. Maltreatment is when a person who is responsible for a person’s care, custody, or control endangers the person’s life or health, denies them food or adequate care, subjects them to strenuous or unsuitable work, or abuses the use of corrective discipline. Abandonment of an incapable person is when a person responsible for another person’s care, custody, or control abandons that person and is unable to defend them from the risks of abandonment. Torture is when someone inflicts severe mental or physical pain or suffering²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

The crime homicide is included in the subgroup crimes against life and is defined as the killing of one human being by another. Verbal abuse, included in the subgroup crimes against honor, is defined as offending someone’s dignity based on race, color, ethnicity, religion, or disability²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

Sexual crimes against a vulnerable person included sexual activity with a person under the age of 14, a person who is incapable of consent, or a person who is unable to resist. The crime rape of a vulnerable person includes victims under the age of 14. Other includes sexual crimes such as the publication and dissemination of rape videos and photographs and enticement/harassment by any means of communication with the aim of engaging in a lewd act²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

The subgroup crimes against sexual freedom includes rape and sexual harassment. Sexual harassment is defined as performing a lewd act with someone without their permission²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

The subgroup indecent public behavior is made up of an obscene act, defined as performing an obscene act in a public place²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

Acts of violence not classified by the Penal Code were included in the group incidents not classified as crimes, made up of the following subgroups: suicide, disappearance of persons, and psychological violence. Disappearance of persons is when a person goes missing from their family and their community²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

The group crimes against the family is made up of the subgroup crimes against parental power, custody and guardianship, which includes abduction of incapable persons, defined as abduction of a minor under the age of 18, or abduction of an incapable person from a parent or guardian²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

The group crimes against property is made up of the subgroup robbery, including robbery murder, defined as robbery resulting in death²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez..

Other variables

The victim variables were age and sex (male and female). Age was divided into two groups: children (0-11 year) and adolescents (12-17 years).

The probable perpetrator variables were sex (male and female) and relationship to the victim. The latter included mother and father (yes or no) and other perpetrators (family member, ex/current boyfriend/girlfriend, acquaintance, and stranger). Self-inflicted and legally confidential violence, and violence committed by an unidentified stranger were excluded from the analysis.

Incident locations included home, school, shelter/penitentiary/reformatory, urban thoroughfare, rural thoroughfare, and the internet (yes or no).

The variables taken from the SIM were year of death and victim sex, covering the period 2014 to 2020.

Data analysis

The descriptive and statistical analyses were performed using Stata 15.0. We performed a temporal analysis of the number of deaths and incidents of violence against children and adolescents per year by sex.

The statistical significance of differences in frequencies of groups and subgroups of violence and types of crimes between the age groups and sexes were tested using Pearson’s chi-squared test or Fisher’s exact test, adopting a significance level of 0.05. If the p-value was < 0.100 in one group, we continued to test the differences in the subgroups. The same criterion was used for the subgroups and types of crimes.

In accordance with National Health Council Resolution 510/2016²⁵25 Brasil. Resolução nº 510, de 7 de abril de 2016. Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais. Diário Oficial da União 2016; 24 maio., the study did not require ethical approval because the data were collected from secondary databases and do not identity the people involved in the cases. The SIM is in the public domain¹⁹19 Brasil. Ministério da Saúde (MS). Sistema de Informações sobre Mortalidade [Internet]. [acessado 2022 mar 10]. Disponível em: https://dados.gov.br/dataset/sistema-de-informacao-sobre-mortalidade
https://dados.gov.br/dataset/sistema-de-... and the data obtained from the SSP-MA observe the principles of confidentiality and privacy of personal information²⁶26 Brasil. Lei nº 12.527, de 18 de novembro de 2011. Regula o acesso a informações previsto no inciso XXXIII do art. 5º, inciso II do § 3º do art. 37 e § 2º do art. 216 da Constituição Federal. Diário Oficial da União 2011; 18 nov..

Results

Between 2014 and 2020, 1,326 deaths due to violence were reported in the 0-17 years age group, comprising 116 children (8.7%) and 1,210 adolescents (91.3%). In the same period, 8,187 IRs of violence against children aged 0-17 years were recorded in the SSP-MA’s systems, most of which (77.3%) involving adolescents.

The number of deaths of children rose and fell alternately over the seven-year study period, with 2014 and 2019 showing the highest and lowest numbers, respectively (Figure 1A). The highest number of deaths of adolescents was recorded in 2015, with annual falls being witnessed between 2016 and 2019, followed by a slight increase in 2020 (Figure 1B). Boys made up most deaths in both age groups in each year of the study period (Figures 1A and 1B).

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Figure 1
Temporal trends in violent deaths of children (1A) and adolescents (1B) in the state of Maranhão reported in the Mortality Information System, Brazil, 2014-2020.

The number of incidents of violence against children fell between 2014 and 2015. Numbers then increased annually up to 2017, followed by a sharp fall in 2018, rising once again in 2019 and 2020 (Figure 2A). The number of reports of violence against adolescents increased between 2014 and 2017, followed by decreases in 2018 and 2019 and an increase in 2020 (Figure 2B). The number of incidents of violence was higher among girls in both age groups in each year of the study period (Figures 2A and 2B).

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Figure 2
Temporal trends of incidents of violence against children and adolescents reported by the State of Maranhão Public Security Department, Brazil, 2014-2020.

The group that accounted for the highest number of victims was crimes against persons, followed by crimes against sexual dignity, incidents not classified as crimes, crimes against the family, and crimes against property (Table 1).

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Table 1
Differences in types of violence against children and adolescents. State of Maranhão Public Security Department, Brazil, 2014-2020.

Among adolescents, crimes against persons accounted for the largest share of incidents of violence, followed by crimes against sexual dignity and incidents not classified as crimes. Crimes against the family (abduction of incapable persons) represented the largest share of incidents of violence against children (p < 0.001 in all analyses) (Table 1).

The following main differences were observed in the subgroups: a) endangerment of life and health, from the group crimes against persons, was the most frequent the subgroup among children (p < 0.001) and crimes against individual liberty (p = 0.004) was the most frequent the subgroup in adolescents, followed by crimes against life (homicide) (p < 0.001); b) sexual crimes against vulnerable persons, from the group crimes against sexual dignity, was the most frequent subgroup in children (p < 0.001) and crimes against sexual freedom was the most frequent subgroup adolescents (p < 0.001); and c) psychological violence, from the group incidents not classified as crimes, was the most frequent subgroup among adolescents (p = 0.034) (Table 1).

Abandonment of an incapable person (p = 0.045), from the subgroup endangerment of life and health, and rape of a vulnerable person (p = 0.003), form the subgroup sexual crimes against vulnerable persons, were the most frequent types of crimes against children (Table 1).

Shaming or embarrassing a child or adolescent and abduction and false imprisonment of a minor under the age of 18, from the category other (p = 0.007) of the subgroup crimes against individual liberty (p = 0.004), and sexual harassment (p < 0.001) were the most frequent types of crime among adolescents (Table 1).

Domestic violence with bodily harm was more frequent in girls in both age groups (p < 0.001). Among adolescents, abduction of incapable persons (p = 0.001), bodily harm (p = 0.001), verbal abuse (p < 0.001), and obscene acts (p = 0.021) were more frequent among girls (Table 2), while bodily harm that endangers life or results in death (p = 0.002), homicide (< 0.001), and criminal coercion (p < 0.001) were more frequent in boys (Table 2).

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Table 2
Differences in types of violence against children and adolescents stratified by sex. State of Maranhão Public Security Department, Brazil, 2014-2020.

The following types of probable perpetrators of violence and incident locations were more frequent in adolescents than in children: father (p = 0.001), mother (p < 0.001), family member (p < 0.001), current/ex-boyfriend (p < 0.001), and stranger (p < 0.001); the home (p < 0.001), urban thoroughfare (p < 0.001), and the internet (p = 0.001) (Table 3).

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Table 3
Characteristics of the victims, probable perpetrators, and incidents of violence among children and adolescents. State of Maranhão Public Security Department, Brazil, 2014-2020.

Discussion

The number of deaths and incidents of violence was higher among adolescents throughout the study period Among adolescents, numbers rose between 2014 and 2015, fell in 2018 and 2019, and increased once again in 2020. Deaths and incidents of violence against children rose slightly between 2019 and 2020. Abduction of incapable persons, abandonment of an incapable person, and rape of a vulnerable person were the most frequent incidents of violence against children, while homicides, crimes against individual liberty (shaming or embarrassing a child or adolescent and abduction and false imprisonment of a minor under the age of 18), crimes against sexual freedom (rape and sexual harassment), and psychological violence were more frequent among adolescents. The number of reports of domestic violence with bodily harm were higher among girls in both age groups. Abduction of incapable persons, bodily harm, verbal abuse, and obscene acts were the most common types of violence among adolescent girls. Grievous bodily harm, homicide, and criminal coercion were the most frequent types of violence among adolescent boys. Incidents of violence committed in the home, public thoroughfares, and the internet were more frequent among adolescents than in children. The following types of probable perpetrators of violence were reported more frequently among adolescents than in children: father, mother, family member, current/ex-boyfriend, and stranger.

Study limitations include: the underreporting of deaths and incidents of violence, as shown by other similar studies³3 Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018.^,⁵5 Macedo DM, Foschiera LN, Bordini TCPM, Habigzang LF, Koller SH. Revisão sistemática de estudos sobre registros de violência contra crianças e adolescentes no Brasil. Cien Saude Colet 2017; 24(2):487-496.^,⁸8 Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915.^,²⁷27 Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf; the lack of availability of IRs for cases recorded in the SIGO; the non-completion of or mistakes in filling out information from IRs in SIGMA; the absence of information on victims’ socioeconomic (family income and education level, among others) and demographic (skin color, for example) characteristic and probable perpetrator in IRs.

Other international studies²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006. and research in different regions^6,9,28,29 and states in Brazil¹³13 Lima AT, Sousa RPR, Clemente SMPS, Viana MAO, Porto E. Perfil epidemiológico da violência contra crianças e adolescentes: uma análise das notificações compulsórias no Estado da Paraíba. Res Soc Dev 2020; 9(10):e1359108421 .

14 Lolli LF, Mesacasa D, Campos FNL, Silva NS, Oliveira VA, Fabiano GR, Dalpoz GQ, Pimentel BV, Freitag IH, Sperandio KCT. Violência praticada contra crianças e adolescentes no estado do Paraná: estudo retrospectivo do quinquênio 2010-2014. Braz J Hea Rev 2020; 3(4):11198-11214.

15 Oliveira NF, Moraes CL, Junger WL, Reichenheim ME. Violência contra crianças e adolescentes em Manaus, Amazonas: estudo descritivo dos casos e análise da completude das fichas de notificação, 2009-2016. Epidemiol Serv Saude 2020; 29(1):e2018438.^-¹⁶16 Cezar PK, Arpini DM, Goetz ER. Registros de notificação compulsória de violência envolvendo crianças e adolescentes. Psicol Cienc Prof 2017; 37(2):432-445.^,²⁷27 Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf have also shown that numbers of deaths and incidents of violence are higher among adolescents. This may be explained by the fact that adolescents are more likely to be involved in criminal groups, gangs and conflict situations, drink and use drugs, handle firearms, and challenge rules²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006.^,³3 Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018.. Furthermore, adolescents are more independent than children in decision making when it comes to reporting violence²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006.^,³3 Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018.^,⁸8 Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915. and less fearful of the consequences. Small children are also unable to clearly describe what has happened²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006.^,²⁷27 Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf.

Our findings show an overall fall in the number of adolescent deaths due to violence in 2018 and 2019 and that this decrease was more pronounced in boys. This trend was also observed at national level⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021.. Factors explaining this trend include demographic transition, characterized by a decline in the population of young people in Brazil, including Maranhão¹⁸18 Instituto Brasileiro de Geografia e Estatística (IBGE). Sistema IBGE de Recuperação Automática: projeção da população [Internet]. [acessado 2021 out 10]. Disponível em: https://sidra.ibge.gov.br/Tabela/7358
https://sidra.ibge.gov.br/Tabela/7358... , the implementation of state violence prevention policies and programs, the enactment of the 2017 Disarmament Statute, which added illegally possessing and carrying a restricted firearm to the list of heinous crimes⁷7 Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021, and the intensification of campaigns encouraging people to report violence³3 Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018.^,⁷7 Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021.

In addition to the above factors, reductions in the number of intentional violent deaths in Brazil between 2017 and 2019 have been attributed to a deterioration in the quality of SIM data on the underlying cause of violent deaths. This problem has been related to an increase in the percentage of violent deaths of undetermined intent, from 6.2% in 2017 to 11.7% in 2019. The fall in the number of deaths due to violence between 2017 and 2019 observed in the present study may therefore be partially attributed to the increase in the number of cases of violent deaths of undetermined intent in Maranhão between 2018 and 2019 (from 73 to 80, equivalent to 9.6%)⁷7 Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021.

The sharp decrease in reports of incidents of violence against children and adolescents between 2017 and 2018 was probably due to problems during the switch from the SIGO to SIGMA, both of which were used simultaneously in 2018²²22 Maranhão. Delegacia Geral da Polícia Civil (DGPC). Portaria nº 430, de 27 de junho de 2018. Regulamenta a utilização de soluções tecnológicas e não tecnológicas como padrões a serem utilizados por toda gestão operacional da Polícia Civil do Estado do Maranhão. Diário Oficial do Estado do Maranhão 2018; 27 jun..

The increase in violence against children and adolescents in 2020 shown by the present study was also observed in the state of São Paulo³⁰30 Oliveira SMT, Galdeano EA, Trindade EMGG, Fernandez RS, Buchaim RL, Buchaim DV, Cunha MR, Passos SD. Epidemiological study of violence against children and its increase during the COVID-19 pandemic. Int J Environ Res Public Health 2022; 18(19): 10061. and in other countries³¹31 Cappa C, Jijon I. COVID-19 and violence against children: a review of early studies. Child Abuse Neglect 2021; 116(2):105053.. This increase has been related to closer proximity for extended periods of time between perpetrators and victims due to the imposition of social distancing measures (suspension of classes, remote working, and other restrictions)¹1 World Health Organization (WHO). Global status report on preventing violence against children. Geneva: WHO; 2020.^,³⁰30 Oliveira SMT, Galdeano EA, Trindade EMGG, Fernandez RS, Buchaim RL, Buchaim DV, Cunha MR, Passos SD. Epidemiological study of violence against children and its increase during the COVID-19 pandemic. Int J Environ Res Public Health 2022; 18(19): 10061.^,³¹31 Cappa C, Jijon I. COVID-19 and violence against children: a review of early studies. Child Abuse Neglect 2021; 116(2):105053., stress (loss of jobs and family income during the pandemic)¹1 World Health Organization (WHO). Global status report on preventing violence against children. Geneva: WHO; 2020.^,³¹31 Cappa C, Jijon I. COVID-19 and violence against children: a review of early studies. Child Abuse Neglect 2021; 116(2):105053., and operational difficulties in child and adolescent protection services¹1 World Health Organization (WHO). Global status report on preventing violence against children. Geneva: WHO; 2020.^,³⁰30 Oliveira SMT, Galdeano EA, Trindade EMGG, Fernandez RS, Buchaim RL, Buchaim DV, Cunha MR, Passos SD. Epidemiological study of violence against children and its increase during the COVID-19 pandemic. Int J Environ Res Public Health 2022; 18(19): 10061.^,³¹31 Cappa C, Jijon I. COVID-19 and violence against children: a review of early studies. Child Abuse Neglect 2021; 116(2):105053. during the COVID-19 pandemic.

The only group of crimes that was more frequent among children than in adolescents was crimes against the family, which includes abduction of incapable persons. Most reports of this type of crime did not mention the probable perpetrator. The probable perpetrator was the father of the child in two cases (victims aged 4 and 5 years) and a neighbor in one case (victim aged 4 years). Among adolescents, abduction of incapable persons was more frequent in girls and the perpetrators were a father (victim aged 17 years) and boyfriend (victims aged 12 to 16 years).

The aim of perpetrators when abducting an incapable person is to integrate the victim into another family²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez.. This crime is often committed during custody disputes, when children lose their father, mother or guardian³²32 Brasil. Ministério das Relações Exteriores (MRE). Cartilha sobre disputa de guarda e subtração internacional de menores. Brasília: Ministério das Relações Exteriores; 2021., or when the child goes to live with another person without parental consent, for example in cases of child marriage³³33 Cardoso AS, Valério ID, Ramos CI, Machado KP. Casamento infantil no Brasil: uma análise da Pesquisa Nacional de Saúde. Cien Saude Colet 2022; 27(2):417-426..

The higher number of abductions of incapable persons among children may be associated with the fact that children have less autonomy to choose who they prefer to live with, often resulting in disputes and violence³²32 Brasil. Ministério das Relações Exteriores (MRE). Cartilha sobre disputa de guarda e subtração internacional de menores. Brasília: Ministério das Relações Exteriores; 2021.. Among adolescents, the fact that this type of crime is more frequent among girls may be due to the fact that teenage girls are more likely to leave home without consent to live with their boyfriend. In such situations, the girl is often pregnant and hides the pregnancy from her family³³33 Cardoso AS, Valério ID, Ramos CI, Machado KP. Casamento infantil no Brasil: uma análise da Pesquisa Nacional de Saúde. Cien Saude Colet 2022; 27(2):417-426.. A follow-up cohort study of adolescents born in Pelotas (Rio Grande do Sul) in 1993 did not find significant differences in the frequency of abduction of incapable persons between sexes⁸8 Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915..

Abandonment of an incapable person, one of the three types of crimes in the subgroup endangerment of life and health, was also more frequent in children. No significant differences were found between sexes. Abandonment of an incapable person is a crime that should be analyzed taking into account the social vulnerability of the victim, as it is often difficult to distinguish between neglect/abandonment and the incapacity of a poor family to provide for a child’s basic needs²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006.^,³⁴34 Reis ERL, Souza SJP, Migoto MT, Weigert SP. Dificuldades dos profissionais de saúde em identificar e notificar a violência infantil. RGS 2017; 17(Supl. 1):63-70..

Crimes against sexual dignity were almost twice as frequent among adolescents. The victims of this group of crimes were predominantly girls in both age groups. Other studies have also shown that sexual violence, in its many dimensions, is in more frequent girls²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006.^,³3 Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018.^,⁸8 Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915.^,¹³13 Lima AT, Sousa RPR, Clemente SMPS, Viana MAO, Porto E. Perfil epidemiológico da violência contra crianças e adolescentes: uma análise das notificações compulsórias no Estado da Paraíba. Res Soc Dev 2020; 9(10):e1359108421 .^,²⁷27 Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf^,³⁵35 Brasil. Ministério da Saúde (MS). Análise epidemiológica da violência sexual contra crianças e adolescentes no Brasil, 2011 a 2017. Boletim Epidemiológico 2018; 49(27):1-17..

Rape of a vulnerable person was more frequent in children than in adolescents. This may be explained by the definition of vulnerable person, which includes children aged 0-11 years and adolescents aged between 12 and 13 anos⁴4 Brasil. Ministério da Mulher, da Família e dos Direitos Humanos (MMFDH). ECA: Estatuto da Criança e do Adolescente - Lei nº 8.069, de 13 de julho de 1990. Brasília: MMFDH; 2019.. The frequency of rape of a vulnerable person was higher in girls in both age groups; however, this finding was not statistically significant.

Sexual harassment was more frequent in adolescents. No significant differences were found between sexes. The crime of teenage rape, defined as the rape of someone aged between 14-17 years, was more frequent in girls; however, this finding was not statistically significant. With regard to sexual crimes, only obscene acts (from the group crimes against sexual dignity) was more frequent in girls.

Homicides and bodily harm that endangers life or results in death were more frequent in adolescent boys. These findings are similar to those of studies in other countries²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006., a nationwide study in Brazil⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021., and a study in Rio de Janeiro²⁷27 Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf. This is explained by the fact that boys are more likely to be involved in criminal groups and gangs⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021.^,⁷7 Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021. A study showed that one quarter of homicides of children and adolescents in the state of Rio de Janeiro in 2017 occurred during police interventions²⁷27 Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf. Studies also reveal racial and socioeconomic disparities in homicide rates, with young black adolescents being disproportionately affected by this crime⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021.^,⁷7 Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021.

Shaming or embarrassing a child or adolescent and abduction and false imprisonment of a minor under the age of 18, which are crimes against individual liberty, were more frequent in adolescents. However, no significant differences were found between sexes. Similar results were reported by the above cohort study in Pelotas⁸8 Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915.. Abduction and false imprisonment are frequently related to unequal power relations between genders and generations²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006..

Criminal coercion was more frequent among adolescent boys and the most common types of location of this type of crime were an urban thoroughfare, home, and school. Criminal coercion is the use of serious threats, physical violence, or substances to reduce a person’s ability to resist to force them to break the law or do something against their will. Examples of criminal coercion include using threats to prevent an adolescent from walking down a road or school corridor and abusing someone because of their sexual orientation. When practiced frequently among peers, criminal coercion is called bullying³⁶36 Fantecelle GM. Da tipificação penal do bullying: modismo ou crime? Águia 2011; 1:70-85..

Psychological violence, which is an incident that is not classified as a crime, was more frequent in adolescents; however, no significant differences were found between sexes. A study in Rio de Janeiro in 2017 reported that psychological violence was more common in girls²⁷27 Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf. Threats, verbal abuse, and shaming are crimes included in the Penal Code that correspond to the definition of psychological violence proposed by the World Health Organization²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006..

Bodily harm suffered in the home environment was more frequent in girls in both age groups, revealing unequal gender relations in these settings²2 Pinheiro PS. World report on violence against children. New York: United Nations; 2006.^,²⁷27 Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf. In contrast to the present study, the above cohort study conducted in Pelotas found that there were no significant differences in the frequency of bodily harm between boys and girls. However, it is important to note that the study did not analyze the crimes in the bodily harm subgroup⁸8 Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915..

Verbal abuse was more common in adolescent girls. This type of crime may carry a connotation of race/skin color, ethnicity, religion, origin, and disability²⁴24 Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez.; however, the motivation behind these crimes were not recorded in the SSP-MA’s databases and the perpetrator was identified only in three cases.

The folowing incident locations and probable perpetrators were more frequent in adolescents than in children: the home, public thoroughfare, and the internet; father, mother, family member, current and ex-boyfriend, and stranger. These findings show that the family and home environment do not provide adequate protection to children and, more especially, adolescents, as envisioned by the ECA⁴4 Brasil. Ministério da Mulher, da Família e dos Direitos Humanos (MMFDH). ECA: Estatuto da Criança e do Adolescente - Lei nº 8.069, de 13 de julho de 1990. Brasília: MMFDH; 2019.. Cybercrimes were approximately ten times more frequent in adolescents. This is explained by the fact that this age group has greater access to social media³3 Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018.^,⁶6 Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021..

The findings of this study reveal differences between sexes in the number of deaths and frequency of incidents of violence according to the groups, subgroups, and types of crimes set out in Brazil’s penal code in both children and adolescents.

In a country with deeply rooted social inequalities exacerbated by the Covid-19 pandemic, it is vital that IRs contain information on skin color, education level and other individual, family, and socioeconomic characteristics of the victim, in order to understand who are the main victims of violence and inform the implementation of effective violence prevention measures.

Acknowledgements

The authors are grateful to the State of Maranhão Public Security Department, which kindly provided copies of the requested datasets and allowed us to analyze the incident reports.

References

¹
World Health Organization (WHO). Global status report on preventing violence against children. Geneva: WHO; 2020.
²
Pinheiro PS. World report on violence against children. New York: United Nations; 2006.
³
Brasil. Ministério dos Direitos Humanos (MDH). Violência contra crianças e adolescentes: análise de cenários e propostas de políticas públicas. Brasília: MDH; 2018.
⁴
Brasil. Ministério da Mulher, da Família e dos Direitos Humanos (MMFDH). ECA: Estatuto da Criança e do Adolescente - Lei nº 8.069, de 13 de julho de 1990. Brasília: MMFDH; 2019.
⁵
Macedo DM, Foschiera LN, Bordini TCPM, Habigzang LF, Koller SH. Revisão sistemática de estudos sobre registros de violência contra crianças e adolescentes no Brasil. Cien Saude Colet 2017; 24(2):487-496.
⁶
Fundo das Nações Unidas para a Infância (UNICEF), Fórum Brasileiro de Segurança Pública (FBSP). Panorama da violência letal e sexual contra crianças e adolescentes no Brasil. Brasília: UNICEF/FBSP; 2021.
⁷
Cerqueira D, Ferreira H, Bueno S, Alves PP, Lima RS, Marques D, Silva FAB, Lunelli IC, Rodrigues RI, Lins GOA, Armstrong KC, Lira P, Coelho D, Barros B, Sobral I, Pacheco D, Pimentel A. Atlas da violência 2021. São Paulo: Fórum Brasileiro de Segurança Pública; 2021
⁸
Gallo, EAG, Menezes AMB, Murray J, Silva LAD, Wehrmeister FC, Gonçalves H, Barros F. Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil. Cad Saude Publica 2016; 32(8):e00072915.
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¹¹
Sousa AYA, Pinho EFS, Silva JTN, Meireles ACV, Lago RJM, Silva WN, Moraes FC. Caracterização dos casos de violência sexual contra a mulher notificados no estado do Maranhão no período de 2009 a 2017. BJD 2021;7(1):9925-9941.
¹²
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¹³
Lima AT, Sousa RPR, Clemente SMPS, Viana MAO, Porto E. Perfil epidemiológico da violência contra crianças e adolescentes: uma análise das notificações compulsórias no Estado da Paraíba. Res Soc Dev 2020; 9(10):e1359108421 .
¹⁴
Lolli LF, Mesacasa D, Campos FNL, Silva NS, Oliveira VA, Fabiano GR, Dalpoz GQ, Pimentel BV, Freitag IH, Sperandio KCT. Violência praticada contra crianças e adolescentes no estado do Paraná: estudo retrospectivo do quinquênio 2010-2014. Braz J Hea Rev 2020; 3(4):11198-11214.
¹⁵
Oliveira NF, Moraes CL, Junger WL, Reichenheim ME. Violência contra crianças e adolescentes em Manaus, Amazonas: estudo descritivo dos casos e análise da completude das fichas de notificação, 2009-2016. Epidemiol Serv Saude 2020; 29(1):e2018438.
¹⁶
Cezar PK, Arpini DM, Goetz ER. Registros de notificação compulsória de violência envolvendo crianças e adolescentes. Psicol Cienc Prof 2017; 37(2):432-445.
¹⁷
Quadros MN, Kirchner RM, Hildebrandt LM, Leite, MT, Costa MC, Sarzi DM. Situação da violência contra crianças e adolescentes no Brasil. Enfermería Global 2016; 15(44):174-185.
¹⁸
Instituto Brasileiro de Geografia e Estatística (IBGE). Sistema IBGE de Recuperação Automática: projeção da população [Internet]. [acessado 2021 out 10]. Disponível em: https://sidra.ibge.gov.br/Tabela/7358
» https://sidra.ibge.gov.br/Tabela/7358
¹⁹
Brasil. Ministério da Saúde (MS). Sistema de Informações sobre Mortalidade [Internet]. [acessado 2022 mar 10]. Disponível em: https://dados.gov.br/dataset/sistema-de-informacao-sobre-mortalidade
» https://dados.gov.br/dataset/sistema-de-informacao-sobre-mortalidade
²⁰
Departamento de Informática do Sistema Único de Saúde (DATASUS). Informações de Saúde: mortalidade [Internet]. [acessado 2021 out 10]. Disponível em: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10uf.def
» http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10uf.def
²¹
Maranhão. Delegacia Geral da Polícia Civil (DGPC). Portaria nº 032, de 2 de fevereiro de 2012. Adota a ferramenta de solução tecnológica SIGO (Sistema Integrado de Gestão Operacional) como sistema padrão a ser utilizado para gestão operacional por toda a Polícia Civil do Estado do Maranhão. Diário Oficial do Estado do Maranhão 2012; 7 fev.
²²
Maranhão. Delegacia Geral da Polícia Civil (DGPC). Portaria nº 430, de 27 de junho de 2018. Regulamenta a utilização de soluções tecnológicas e não tecnológicas como padrões a serem utilizados por toda gestão operacional da Polícia Civil do Estado do Maranhão. Diário Oficial do Estado do Maranhão 2018; 27 jun.
²³
Maranhão. Instrução Normativa nº 002, de abril de 2012. Normatiza e disciplina os procedimentos policiais e outros atos da Polícia Civil. Diário Oficial do Estado do Maranhão 2012; 23 mai.
²⁴
Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez.
²⁵
Brasil. Resolução nº 510, de 7 de abril de 2016. Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais. Diário Oficial da União 2016; 24 maio.
²⁶
Brasil. Lei nº 12.527, de 18 de novembro de 2011. Regula o acesso a informações previsto no inciso XXXIII do art. 5º, inciso II do § 3º do art. 37 e § 2º do art. 216 da Constituição Federal. Diário Oficial da União 2011; 18 nov.
²⁷
Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf
²⁸
Malta DC, Minayo MCS, Cardoso LSM, Veloso GA, Teixeira RA, Pinto IV, Naghavi, M. Mortalidade de adolescentes e adultos jovens brasileiros entre 1990 e 2019, uma análise do estudo Carga Global de Doença. Cien Saude Colet 2021; 26(9):4069-4086.
²⁹
Paungartner LM, Moura JQ, Fernandes MTC, Paiva TS. Análise epidemiológica das notificações de violência contra crianças e adolescentes no Brasil de 2009 a 2017. REAS 2020; 12(9):e4241.
³⁰
Oliveira SMT, Galdeano EA, Trindade EMGG, Fernandez RS, Buchaim RL, Buchaim DV, Cunha MR, Passos SD. Epidemiological study of violence against children and its increase during the COVID-19 pandemic. Int J Environ Res Public Health 2022; 18(19): 10061.
³¹
Cappa C, Jijon I. COVID-19 and violence against children: a review of early studies. Child Abuse Neglect 2021; 116(2):105053.
³²
Brasil. Ministério das Relações Exteriores (MRE). Cartilha sobre disputa de guarda e subtração internacional de menores. Brasília: Ministério das Relações Exteriores; 2021.
³³
Cardoso AS, Valério ID, Ramos CI, Machado KP. Casamento infantil no Brasil: uma análise da Pesquisa Nacional de Saúde. Cien Saude Colet 2022; 27(2):417-426.
³⁴
Reis ERL, Souza SJP, Migoto MT, Weigert SP. Dificuldades dos profissionais de saúde em identificar e notificar a violência infantil. RGS 2017; 17(Supl. 1):63-70.
³⁵
Brasil. Ministério da Saúde (MS). Análise epidemiológica da violência sexual contra crianças e adolescentes no Brasil, 2011 a 2017. Boletim Epidemiológico 2018; 49(27):1-17.
³⁶
Fantecelle GM. Da tipificação penal do bullying: modismo ou crime? Águia 2011; 1:70-85.

Publication Dates

Publication in this collection
16 Jan 2023
Date of issue
Feb 2023

History

Received
22 Mar 2022
Accepted
11 July 2022
Published
13 July 2022

Este é um artigo publicado em acesso aberto sob uma licença Creative Commons

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Sousa AYA, Pinho EFS, Silva JTN, Meireles ACV, Lago RJM, Silva WN, Moraes FC. Caracterização dos casos de violência sexual contra a mulher notificados no estado do Maranhão no período de 2009 a 2017. BJD 2021;7(1):9925-9941.

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Conselho Estadual dos Direitos da Criança e do Adolescente do Maranhão, Centro de Defesa dos Direitos da Criança e do Adolescente Pe. Marcos Passerini. Observatório Criança: acompanhando a situação dos direitos da criança e do adolescente no Maranhão de 2006 a 2010. São Luís: CEDCA/CDMP; 2014.

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Lima AT, Sousa RPR, Clemente SMPS, Viana MAO, Porto E. Perfil epidemiológico da violência contra crianças e adolescentes: uma análise das notificações compulsórias no Estado da Paraíba. Res Soc Dev 2020; 9(10):e1359108421 .

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Lolli LF, Mesacasa D, Campos FNL, Silva NS, Oliveira VA, Fabiano GR, Dalpoz GQ, Pimentel BV, Freitag IH, Sperandio KCT. Violência praticada contra crianças e adolescentes no estado do Paraná: estudo retrospectivo do quinquênio 2010-2014. Braz J Hea Rev 2020; 3(4):11198-11214.

[15] ¹⁵
Oliveira NF, Moraes CL, Junger WL, Reichenheim ME. Violência contra crianças e adolescentes em Manaus, Amazonas: estudo descritivo dos casos e análise da completude das fichas de notificação, 2009-2016. Epidemiol Serv Saude 2020; 29(1):e2018438.

[16] ¹⁶
Cezar PK, Arpini DM, Goetz ER. Registros de notificação compulsória de violência envolvendo crianças e adolescentes. Psicol Cienc Prof 2017; 37(2):432-445.

[17] ¹⁷
Quadros MN, Kirchner RM, Hildebrandt LM, Leite, MT, Costa MC, Sarzi DM. Situação da violência contra crianças e adolescentes no Brasil. Enfermería Global 2016; 15(44):174-185.

[18] ¹⁸
Instituto Brasileiro de Geografia e Estatística (IBGE). Sistema IBGE de Recuperação Automática: projeção da população [Internet]. [acessado 2021 out 10]. Disponível em: https://sidra.ibge.gov.br/Tabela/7358
» https://sidra.ibge.gov.br/Tabela/7358

[19] ¹⁹
Brasil. Ministério da Saúde (MS). Sistema de Informações sobre Mortalidade [Internet]. [acessado 2022 mar 10]. Disponível em: https://dados.gov.br/dataset/sistema-de-informacao-sobre-mortalidade
» https://dados.gov.br/dataset/sistema-de-informacao-sobre-mortalidade

[20] ²⁰
Departamento de Informática do Sistema Único de Saúde (DATASUS). Informações de Saúde: mortalidade [Internet]. [acessado 2021 out 10]. Disponível em: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10uf.def
» http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10uf.def

[21] ²¹
Maranhão. Delegacia Geral da Polícia Civil (DGPC). Portaria nº 032, de 2 de fevereiro de 2012. Adota a ferramenta de solução tecnológica SIGO (Sistema Integrado de Gestão Operacional) como sistema padrão a ser utilizado para gestão operacional por toda a Polícia Civil do Estado do Maranhão. Diário Oficial do Estado do Maranhão 2012; 7 fev.

[22] ²²
Maranhão. Delegacia Geral da Polícia Civil (DGPC). Portaria nº 430, de 27 de junho de 2018. Regulamenta a utilização de soluções tecnológicas e não tecnológicas como padrões a serem utilizados por toda gestão operacional da Polícia Civil do Estado do Maranhão. Diário Oficial do Estado do Maranhão 2018; 27 jun.

[23] ²³
Maranhão. Instrução Normativa nº 002, de abril de 2012. Normatiza e disciplina os procedimentos policiais e outros atos da Polícia Civil. Diário Oficial do Estado do Maranhão 2012; 23 mai.

[24] ²⁴
Brasil. Decreto-Lei nº 2.848, de 7 de dezembro de 1940. Código Penal Brasileiro. Diário Oficial da União 1940; 31 dez.

[25] ²⁵
Brasil. Resolução nº 510, de 7 de abril de 2016. Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais. Diário Oficial da União 2016; 24 maio.

[26] ²⁶
Brasil. Lei nº 12.527, de 18 de novembro de 2011. Regula o acesso a informações previsto no inciso XXXIII do art. 5º, inciso II do § 3º do art. 37 e § 2º do art. 216 da Constituição Federal. Diário Oficial da União 2011; 18 nov.

[27] ²⁷
Manso FV, Gonçalves LL, organizadores. Dossiê criança e adolescente 2018 [Internet]. Rio de Janeiro: Instituto de Segurança Pública; 2018. [acessado 2022 mar 10]. Disponível em: https://assets-dossies-ipg-v2.nyc3.digitaloceanspaces.com/sites/3/2019/02/2018_DossieCrincadolescente.pdf

[28] ²⁸
Malta DC, Minayo MCS, Cardoso LSM, Veloso GA, Teixeira RA, Pinto IV, Naghavi, M. Mortalidade de adolescentes e adultos jovens brasileiros entre 1990 e 2019, uma análise do estudo Carga Global de Doença. Cien Saude Colet 2021; 26(9):4069-4086.

[29] ²⁹
Paungartner LM, Moura JQ, Fernandes MTC, Paiva TS. Análise epidemiológica das notificações de violência contra crianças e adolescentes no Brasil de 2009 a 2017. REAS 2020; 12(9):e4241.

[30] ³⁰
Oliveira SMT, Galdeano EA, Trindade EMGG, Fernandez RS, Buchaim RL, Buchaim DV, Cunha MR, Passos SD. Epidemiological study of violence against children and its increase during the COVID-19 pandemic. Int J Environ Res Public Health 2022; 18(19): 10061.

[31] ³¹
Cappa C, Jijon I. COVID-19 and violence against children: a review of early studies. Child Abuse Neglect 2021; 116(2):105053.

[32] ³²
Brasil. Ministério das Relações Exteriores (MRE). Cartilha sobre disputa de guarda e subtração internacional de menores. Brasília: Ministério das Relações Exteriores; 2021.

[33] ³³
Cardoso AS, Valério ID, Ramos CI, Machado KP. Casamento infantil no Brasil: uma análise da Pesquisa Nacional de Saúde. Cien Saude Colet 2022; 27(2):417-426.

[34] ³⁴
Reis ERL, Souza SJP, Migoto MT, Weigert SP. Dificuldades dos profissionais de saúde em identificar e notificar a violência infantil. RGS 2017; 17(Supl. 1):63-70.

[35] ³⁵
Brasil. Ministério da Saúde (MS). Análise epidemiológica da violência sexual contra crianças e adolescentes no Brasil, 2011 a 2017. Boletim Epidemiológico 2018; 49(27):1-17.

[36] ³⁶
Fantecelle GM. Da tipificação penal do bullying: modismo ou crime? Águia 2011; 1:70-85.

Types of violence	Total	Children^a		Adolescents^a		p-value
Types of violence	n	n	%	n	%
Groups	8,187	1,857	22.7	6,330	77.3	<0.001
Crimes against persons	5,232	1,141	21.8	4,091	78.2	<0.001
Crimes against sexual dignity	1,844	637	34.5	1,207	65.5	<0.001
Incidents not classified as crimes	1,070	59	5.5	1,011	94.5	<0.001
Crimes against the family (just the subgroup crimes against parental power, custody and guardianship, with the crime abduction of incapable persons)^b	39	20	51.3	19	48.7	<0.001
Crimes against property (just the subgroup robbery, with the crime robbery murder)^c	2	0	0.0	2	100.0	-
Subgroups
Group crimes against persons	5,232	1,141	21.8	4,091	78.2	< 0.001
Bodily harm^d	1,981	456	23.0	1,525	77.0	0.280
Crimes against individual liberty^e	1,711	233	13.6	1,478	86.4	0.004
Endangerment of life and health^f	326	244	74.8	82	25.2	0.024
Crimes against life (just homicide)^g	985	153	15.5	832	84.5	< 0.001
Crimes against honor (just verbal abuse)^h	229	55	24.0	174	76.0	0.415
Group crimes against sexual dignity	1,844	637	34.5	1,207	65.5	< 0.001
Sexual crimes against vulnerable personsⁱ	1,119	625	55.9	494	44.1	< 0.001
Crimes against sexual freedom^j	713	8	1.1	705	98.9	< 0.001
Indecent public behavior (the crime obscene act)^k	12	4	33.3	8	66.7	0.999ⁿ
Group incidents not classified as crimesl	1,070	59	5.5	1,011	94.5	0.058
Disappearance of persons	1,027	55	5.4	972	94.6	0.923
Suicide	30	1	3.3	29	96.7	0.999⁴
Psychological violence	13	3	23.1	10	76.9	0.034ⁿ
Crimes in subgroups
Crimes against individual liberty^e	1,711	233	13.6	1,478	86.4	0.004
Threats	1,382	172	12.4	1,210	87.6	0.362
Criminal coercion	168	26	15.5	142	84.5	0.483
Other^m	161	35	21.7	126	78.3	0.007
Endangerment of life and health^g	326	244	74.8	82	25.2	0.024ⁿ
Maltreatment	250	179	71.6	71	28.4	0.393
Abandonment of an incapable person	73	63	86.3	10	13.7	0.045
Torture	3	2	66.7	1	33.3	-
Sexual crimes against vulnerable personsi	1,119	625	55.8	494	44.2	< 0.001
Rape of a vulnerable person	941	588	62.5	353	37.5	0.003
Other	178	37	20.8	141	79.2	0.001
Subgroup crimes against sexual freedom^j	713	8	1.1	705	98.9	< 0.001
Rape	656	-	-	656	100.0	-
Sexual harassment	57	8	14.0	49	86.0	< 0.001

Types of violence	Children^a				Adolescents^a
	Boys^b	Girls^c	p-value	Total	Boys^b	Girls^c	p-value	p- value
		n (%)	n (%)			n (%)	n (%)
Groups of crimes	1,801	754(41.9)	1,047(58.1)	<0.001	6,267	2,484(39.7)	3,783(60.4)	<0,001
Crimes against persons	1,101	598(54.3)	503(45.7)	<0.001	4,057	2,015(49.7)	2,042(50.3)	<0,001
Crimes against sexual dignity	624	115(18.4)	509(81.6)	<0.001	1,191	94(7.9)	1,097(92.1)	<0,001
Incidents not classified as crimes	57	35(61.4)	22(38.6)	0.004	998	372(37.3)	626(62.7)	0,163
Crimes against the family (abduction of incapable persons)^d	19	6(31.6)	13(68.4)	0.485	19	1(5.3)	18(94.7)	0,001
Crimes against property (robbery murder)^e	0	0	0	-	2	2(100.0)	0(0.0)	-
Group with subgroups of crimes, without type of crime
Group Incidents not classified as crimes^f	57	35(61.4)	22(38.6)	0.004	998	372(37.3)	626(62.7)	0,163
Disappearance of persons	54	33(61.1)	21(38.9)	0.999	961	355(36.9)	606(63.1)	0,888
Suicide	1	0(0.0)	1(100.0)	-	27	15(55.6)	12(44.4)	0,069
Psychological violence	2	2(100.0)	0(0.0)	-	10	2(20.0)	8(80.0)	0,338^o
Crimes
Bodily harm^g	448	248(55.4)	200(44.6)	<0.001	1.509	639(42.3)	870(57.7)	<0,001
Bodily harm	342	210(61.4)	132(38.6)	0.095	1.201	587(48.9)	614(51.1)	0,001
Domestic violence	99	34(34.3)	65(65.7)	<0.001	289	37(12.8)	252(87.2)	<0,001
Other	7	4(57.1)	3(42.9)	^0.999o	19	15(78.9)	4(21.1)	0,002^o
Crimes against individual liberty^h	219	122(55.7)	97(44.3)	0.251	1.462	538(36.8)	924(63.2)	<0,001
Threats	164	93(56.7)	71(43.3)	0.917	1.199	429(35.8)	770(64.2)	0,599
Criminal coercion	23	15(65.2)	8(34.8)	0.508	139	73(52.5)	66(47.5)	<0,001
Other	32	14(43.7)	18(56.3)	0.255	124	36(29.0)	88(71.0)	0.098
Endangerment of life and healthⁱ	236	122(51.7)	114(48.3)	0.584	82	31(37.8)	51(62.2)	0,467
Maltreatment	60	35(58.3)	25(41.7)	0.387	10	3(30.0)	7(70.0)	0,740^o
Abandonment of an incapable person	174	86(49.4)	88(50.6)	0.690	71	27(38.0)	44(62.0)	0,999
Torture	2	1(50.0)	1(50.0)	-	1	1(100.0)	0(0.0)	-
Crimes against life (homicide)^j	144	80(55.6)	64(44.4)	0.790	831	768(92.4)	63(7.6)	<0,001
Crimes against honor (verbal abuse)^k	54	26	28	0.403	173	39(22.5)	134(77.5)	<0,001
Sexual crimes against vulnerable persons^l	612	113(18.5)	499(81.5)	0.610	487	40(8.2)	447(91.8)	0,101
Rape of a vulnerable person	575	105(18.3)	470(81.7)	0.940	347	24(6.9)	323(93.1)	0,512
Other	37	8(21.6)	29(78.4)	0.663	140	16(11.4)	124(88.6)	0,242
Crimes against sexual freedom^m	8	0(0.0)	8(100.0)	-	696	51(7.3)	645(92.7)	0,366
Rape	8	0(0.0)	8(10.0)	-	647	49(7.6)	598(92.4)	0,917
Sexual harassment	0	0(0.0)	0(0.0)	-	49	2(4.1)	47(95.9)	0,568^o
Indecent public behavior (obscene act)ⁿ	4	2(50.0)	2(50.0)	-	8	3(37.5)	5(62.5)	0,021^o

Variables	Total	Children^a		Adolescents^a		p-valor^b
Variables	n	n	%	n	%
Incidents						0.089
Sex (n = 8,068)^c
Male	3,238	754	23.3	2,484	76.7
Female	4,830	1,047	21.7	3,783	78.3
Perpetrators
Sex (n = 1,032)^d						0.062
Male	823	178	21.6	645	78.4
Female	209	40	19.1	169	80.9
Relationship to the victim (n = 1,032)^d
Father						0.001
No	963	193	20.0	770	80.0
Yes	69	25	36.2	44	63.8
Mother						< 0.001
No	991	200	20.2	791	79.8
Yes	41	18	43.9	23	56.1
Family member						< 0.001
No	714	108	15.1	606	84.9
Yes	318	110	34.6	208	65.4
Ex/current boyfriend/girlfriend						< 0.001
No	886	215	24.3	671	75.7
Yes	146	3	2.1	143	97.9
Acquaintance						0.517
No	635	130	20.5	505	79.5
Yes	397	88	22.8	309	77.8
Stranger						< 0.001
No	861	201	23.3	660	76.7
Yes	171	17	9.9	154	90.1
Incident location (n = 7,361)^e
Home						< 0.001
No	2,929	883	30.1	2,046	69.9
Yes	4,432	917	20.7	3,515	79.3
School						0.893
No	445	110	24.7	335	75.3
Yes	6,916	1,690	24.4	5,226	75.6
Shelter/penitentiary/reformatory						0.067
No	41	5	12.2	36	87.8
Yes	7,320	1,795	24.5	5,525	75.5
Urban thoroughfare						< 0.001
No	2,890	556	19.2	2,334	80.8
Yes	4,471	1,244	27.8	3,227	72.2
Rural thoroughfare						0.100
No	439	93	21.2	346	78.8
Yes	6,922	1,707	24.7	5,215	75.3
The internet						0.001^f
No	50	3	6.0	47	94.0
Yes	7,311	1,797	24.6	5,514	75.4

Saúde Pública

Saúde Pública

Deaths, crimes and violence not classified as a crime among children and adolescents in Maranhão, Brazil (2014 to 2020)

Abstract

Introduction

Methods

Study location and population

Data collection

SIGO and SIGMA

Variables based on the Penal Code

Other variables

Data analysis

Results

Discussion

Acknowledgements

References

Publication Dates

History